中国脑血管病杂志2011，Vol.8Issue(6)：313-317,5.DOI:10.3969/j.issn.1672-5921.2011.06.008
经颅多普勒搏动指数预测脑白质病变程度的初步研究
Predicting the severity of white matter lesions with transcranial Doppler pulsatility index: a preliminary study
陈仰昆 1肖卫民 1刘勇林 1李婉仪 1石铸 1方学文1
作者信息
- 1. 523000,广东省东莞市人民医院神经内科
- 折叠
摘要
Abstract
Objective To investigate the relation between the pulsatility index (PI) measured with transcranial Doppler (TCD) and the severity of white matter lesions (WMLs) in patients with lacunar infarction. Methods A total of 93 patients with lacunar infarction of non-cardiac origin and without extracranial-intracranial large artery stenosis were recruited. The patients were divided into either a non-ormild WML group (0 - 3 points, n = 57) and a moderate-to-severe WML group (4 - 6 points, n = 36). All the patients underwent TCD examination. Their PI of middle cerebral artery (PI-MCA) and PI of basilar artery (PI-BA) were measured. The logistic regression analysis was used to study the risk factors for moderate-to-severe WMLs and the relationship between PI and the severity of WMLs. Results ① The PI-MCA ( 1.10 ± 0. 21 ) and PI-BA ( 1.06 ± 0. 25) in the moderate-to-severe WML group were higher than 0. 91 ±0. 13 and 0. 88 ± 0. 10 in the non or mild WML group. There were significant differences (P ＜ 0. 001 ); ②Multiple logistic regression analysis showed that PI-MCA, PI-BA, serum homocysteine concentration and the history of previous stroke were the independent predictors for moderate-to-severe WMLs in patients with lacunar infarction. ③Receiver operator curve (ROC) analysis showed that when PI-MCA was ≥ 0.98, the prediction of the area under the curve of moderate-to-severe WMLs was 0. 811, the sensitivity was 83.3％ , specificity was 78.9％ , positive predictive value was 71.4％ , and negative predictive value was 88.2％. When PI-BA was ≥ 0.95, the prediction of the area under the curve of moderate-to-severe WMLs was 0. 702, the sensitivity was 66.7％ , specificity was 73.7％, positive predictive value was 61.5％ , and negative predictive value was 77.8％. Conclusion PI is a physiological index of reflecting the severity of WMLs. Using TCD to detect the PI value of MCA contributes to predict the severity of white matter lesions in patients with lacunar infarction.关键词
大脑中动脉/超声检查,多普勒,经颅/卒中/磁共振成像/脑白质病变Key words
Middle cerebral artery/ Ultrasonography Doppler, transcranial/ Stroke/ Magnetic resonance imaging/ White matter lesions引用本文复制引用
陈仰昆,肖卫民,刘勇林,李婉仪,石铸,方学文..经颅多普勒搏动指数预测脑白质病变程度的初步研究[J].中国脑血管病杂志,2011,8(6):313-317,5.
